Selection of diagnostic tests for clinical decision making and translation to a problem oriented medical record

Clinica Chimica Acta; International Journal of Clinical Chemistry
Giuseppe RealdiNicola Vitturi

Abstract

The leading function of the physician is the clinical reasoning, which involves appropriate investigation of the problems of the patient, formulation of a diagnostic suspect based on the patient's symptoms and signs, gathering of additional relevant information, to select necessary tests and administration of the most suitable therapy. The problems of the patient are expressed by symptoms or signs or abnormal test results, requested for a variety of reasons. The entire scientific, as well as diagnostic approach, is based on three steps: to stumble in a problem; to try a solution through a hypothesis; to disprove or to prove the hypothesis by a process of criticism. Clinicians use the information obtained from the history and physical examination to estimate initial (or pre-test) probability and then use the results from tests and other diagnostic procedures to modify this probability until the post-test probability is such that the suspected diagnosis is either confirmed or ruled out. When the pre-test probability of disease is high, tests characterized by high specificity will be preferred, in order to confirm the diagnostic suspect. When the pre-test probability of disease is low, a test with high sensitivity is advisable to ...Continue Reading

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Citations

Nov 2, 2011·Internal and Emergency Medicine·Giuseppe RealdiFranco Tosato
Oct 30, 2009·Clinical Chemistry and Laboratory Medicine : CCLM·María Concepción Alonso-CerezoVerónica Marcos de la Iglesia
Sep 1, 2011·Journal of Ultrasound·F SimoniG Realdi
Sep 2, 2010·The Korean journal of laboratory medicine·Hyun Chul LeeKyung Eun Song
Jul 6, 2019·Computational and Mathematical Methods in Medicine·Sorana D Bolboacă
May 28, 2021·Journal of Biomedical Informatics·Yang YangShengping Liu

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